CERTIFICATE OF LIABILITY INSURANCE (618)'`�`� �� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE1HOL�DER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement s.
PRODUCER CONTACT
Insurance Agency of the South LLC NAME:
dba Advanced Comp P"o"E , g63-646-3332 F^'� . 863-646-5004
170 Fitzgerald Road E-""^�� .wccertificate@advancedcomp.net
Lakeland FL 33813
INSURED ROWLINC-01
Rowland, Inc.
6855102nd Avenue
Pinellas Park FL 33782
c:
E:
Ins.
10701
COVERAGES CERTIFICATE NUMBER: 1086190207 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. N0TIMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AlL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR POLICY EFP POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $
CLAIMS-MADE � OCCUR DAMAGE TO RENTED
PREMISES Ea occurrence $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PR� � GENERALAGGREGATE $
JECT LOC
OTHER:
PRODUCTS-COMP/OPAGG $
$
AUTOMOBILE LIABILITY
Ea accident $
ANY AUTO BODILY INJURY (Per person) $
AUTOS�ED AUTOSULED
HIREDAUTOS NON-OWNED
BODILY INJURY (Peraccident) $
AUTOS PROPERTY DAMAGE $
Per accident
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE
$
EXCESS LIAB CLAIMS-MADE AGGREGATE
$
DED RETENTION$
$
q WORKERS COMPENSA710N 083011902 /1/2015 /1/2016 X PER OTH-
AND EMPLOYERS' LIABILITY Y� N STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED? C ��/� E.L.EACHACCIDENT $1,000,000
(MandatoryinNH) E.L.DISEASE-EAEMPLOYE $1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 701, Additional Remarks Schetlule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
City of Clearwater
PO Box 4748
Clearwater FL 33758
ACORD 25 (2014/01)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POL,ICY PROVISIONS.
AUTNORI2ED REPRESENTATIVE
F`� � �a`�
OO 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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